COMPLICATIONS AND FOLLOW-UP AFTER INTRACORONARY STENTING - CRITICAL ANALYSIS OF A 6-YEAR SINGLE-CENTER EXPERIENCE

From April 1986 through April 1992, 123 patients received 153 intracor onary stents (131 Medinvent, 13 Palmaz-Schatz, 9 Wiktor) during 131 pr ocedures. The indication was bail-out treatment in 39, restenosis in 5 9 native coronary arteries, and stenosis or restenosis in 33 vein graf ts. Stent-related events were studied during the in-hospital stay and on follow-up and included closure, stent restenosis, myocardial infarc tion, death, and the need for coronary bypass surgery. A Kaplan-Meier estimate extended to 6 years showed different short- and long-term out comes for the distinct treatment groups (p < 0.05): right coronary-art ery stenting (more particularly, stenting for restenosis after angiopl asty) had the lowest and vein graft stenting had the highest stent-rel ated complication rate. The complication rate was similar (p > 0.25) ( 1) in the case of multiple nontandem stent implantation during the sam e procedure; (2) for the different endoprosthesis sizes; and (3) durin g the different procedural years. In native coronary arteries, resteno sis after angioplasty of the right coronary artery could be a preferen tial indication for coronary artery stenting. Despite a favorable shor t-term outcome, vein graft stenting has a high incidence of events on long-term follow-up, mainly because of late restenosis. Multiple nonta ndem stenting during the same procedure is not associated with a highe r incidence of complications, in particular, the restenosis rate is no t appreciably higher. Finally, only a minor benefit for the learning c urve is apparent from this single-center experience with continual unc hanged postprocedural management.